Gut Health

Imbalances in the gut microbiome contribute to a number of pathologies, such as Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS), pouchitis, obesity and allergies. Building upon exciting new advances in microbial signalling and functionality, NIHR Imperial BRC Gut Health Theme operates in close partnership with the BRC’s Institute of Translational Medicine and Therapeutics (ITMAT) to integrate and model multi-omic data for patient stratification, as well as identify novel therapeutic interventions through harnessing the power of the microbiome in patients with inflammatory diseases of the gut. Our current areas of research are summarised below.

Metabolic and microbial characterisation of IBD

As current therapeutic approaches in treatment of IBD are ineffective in approximately 30% of cases, our in-depth analysis of the microbiome and the metabolome of IBD patients aims to identify actionable biomarkers for improved clinical management of the disease. We are combining expertise in both metabolic phenotyping of biofluids and next generation sequencing of stool samples to establish the composition and functional capacity of the microbiome in IBD.

Microbiome-driven patient stratification for cancer risk prediction

The risk of developing colon cancer is increased in IBD patients, and we are retrospectively analysing IBD biopsies and peripheral biofluids available in our tissue biobanks using a range of new surgical and analytical technologies, to establish bacterial or metabolic markers of susceptibility to colorectal cancer. This will allow better stratification of patients at risk, and will establish microbially-driven inflammatory cascades involved in GI disease and oncogenesis.

Nutritional strategies for management of IBD

Environment, lifestyle, diet and genetic factors play a key role in the increased prevalence of IBD. We are in process of broadly investigating the impact of dietary interventions on IBD expression and management. Improvement in nutritional support for IBD patients taking into account diet-microbiome interactions has the potential to beneficially mediate disease progression.

Extreme IBD phenotypes

We currently have access to large clinical cohorts of well-phenotyped patients, capturing cases that manifest particularly aggressive disease paths, where treatments are of varying efficacy and cost. We aim to enrol and follow 200 patients with IBD, using a combination of traditional metrics of disease and the metabolic and microbial phenotyping resources available through the Clinical Phenome Centre (cross cutting Molecular Phenomics theme), in order to address the role of the microbiome and its metabolic influences in IBD treatment.

NIHR Imperial BRC Gut Health Theme affiliations: